"A person who loses a significant amount of weight, either through dietary changes or weight-loss surgery, typically is burdened with excess skin that drapes over the waist and hangs from the arms and legs," Dr. Reuben says. "The physical health benefits of losing weight are often offset by depression and anxiety because they still feel self-conscious about these things. I have seen firsthand that cosmetic procedures can help."

The study published in the June issue of the journal Plastic and Reconstructive Surgery® showed that virtually all of the 58 patients who participated in the study wanted body contouring surgery after undergoing weight-loss surgery. Dr. Reuben says post-weight loss cosmetic surgery includes several options meant to remove excess stretched skin, including upper and lower body lift procedures, tummy tucks, arm lifts, and thigh lifts. These procedures are often supplemented with liposuction.

The Midvale board-certified plastic surgeon says the study indicated that cost prevents most patients from going through with the body contouring procedures from which they could psychologically benefit. He says that leads him to believe post-weight loss surgery should be considered reconstructive, rather than cosmetic.

That was the conclusion of another study published last year in Plastic and Reconstructive Surgery. If body contouring surgery following weight loss was considered reconstructive instead of cosmetic, a patient's health insurance carrier would be more likely to cover all or part of the cost. Dr. Reuben says that is something many plastic surgeons, including him, support.

"These studies indicate that bariatric surgery is only the first stage in a patient's personal transformation to lead a healthier life," he says. "The earlier study also showed that patients who undergo body contouring surgery are more likely to control their weight in the future."

The recent study's authors suggested that if additional research replicates their findings, then "funding for body-contouring surgery may need to be reevaluated if the goal of bariatric surgery is to enhance the physical and mental well-being of patients."

In the meantime, Dr. Reuben encourages post-weight loss patients to explore financing options for body contouring procedures such as tummy tuck surgery. At his Midvale practice, he offers various financing and credit plans to help people afford the care that he believes goes far beyond cosmetic.

"I know the mental and emotional benefits of these procedures can be just as real as the physical benefits of bariatric surgery," he says, "even if you can't see them."